Systematic review and meta-analysis of studies of immune checkpoint inhibition for advanced hepatocellular carcinoma and impaired liver function

Immune checkpoint inhibitors (ICIs) are increasingly used in patients with advanced hepatocellular carcinoma (aHCC). However, data on ICI therapy in patients with aHCC and impaired liver function are scarce. In a systematic review and meta-analysis of 22 studies involving 699 patients with Child-Pugh B and 2114 patients with Child-Pugh A aHCC, ICI therapy in the Child-Pugh B group appeared to be safe and showed a significant rate of radiologic responses, but survival outcomes were inferior compared with the Child-Pugh A group. The authors conclude that these findings suggest that although the overall prognosis is still poor for patients with aHCC, a proportion of patients with Child-Pugh B liver function might benefit from ICI therapy.